Muscular Dystrophy / ALS

Neurology / Neuroscience

ALS: Treatments and Prevention

Written by James McIntoshReviewed by Dr Helen Webberley
Knowledge center
Last updated: Fri 6 May 2016
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Treatments for ALS

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There is no cure for ALS and so treatment focuses on alleviating the effects of the
symptoms, preventing the development of unnecessary complications and, potentially,
slowing down the rate at which the disease progresses.
As the effects of ALS can cause a range of physical, mental and social changes
for patients, it is often beneficial for patients to work with an integrated
multidisciplinary team of doctors to help them manage their symptoms and care.
An integrated team can help improve the quality of life of people living with ALS
and prolong survival.
Riluzole (Rilutek) is the only drug that has been approved for ALS treatment by the
Food and Drug Administration (FDA). In some people, it slows the progression of the
disease and may work by reducing the body's levels of glutamate, an excitotoxin that
has been linked to neuronal damage. Doctors can also prescribe medication to treat
many of the symptoms of ALS.

Therapy

Support groups can provide emotional support for patients and carers alike.

Physical therapy can help people with ALS to manage pain and address mobility
issues. Low-impact exercises can improve cardiovascular fitness and a patient's sense
of well-being. Physical therapists can also help patients adapt to using mobility aids
such as walkers and wheelchairs and make suggestions with regards to devices, such
as ramps, that can make getting about easier.
Occupational therapy can help people with ALS maintain their independence for
longer. Occupational therapists can suggest adaptive equipment and assistive
technologies to enable people to continue their daily routines. Therapists can also train
people to compensate for hand and arm weaknesses.
Breathing therapy may be required as the disease progresses and the respiratory
muscles get weaker. Doctors can provide devices to assist breathing at night, and

mechanical ventilation is also an option. In mechanical ventilation, a tube connected to

a respirator is inserted in a surgically created hole in the neck (tracheostomy) into the
windpipe.
Speech therapy is useful when ALS begins to affect the muscles involved in speech.
Speech therapists can teach adaptive techniques when speech becomes difficult. Other
methods of communication such as writing can be discussed, as can computer-based
communications equipment.
Nutritional support is important for people suffering for ALS as the disease can
compromise food intake by causing difficulties swallowing. Nutritionists can advise
patients and caregivers on how to prepare meals that are easier to swallow while
meeting all of the individual's nutritional needs. Suction devices and feeding tubes can
also be employed to help people who are able to ingest food orally, rather than
parenterally.
Psychological and social support is important for helping patients and caregivers with
the emotional and financial challenges that are created by ALS, particularly as the
disease progresses. Support groups can provide comfort and insight through shared
experiences, for both patients, family and friends alike.

Recent developments on ALS treatment from MNT news

New small molecules target mutation in ALS and a form of dementia
For the first time, researchers have successfully constructed a strategy targeting a
specific genetic mutation that causes amyotrophic lateral sclerosis and a type of
dementia. And the exciting news is that their findings show it may be possible to treat a
large number of patients who have these two diseases.
Copper compound could form basis for first Lou Gehrig's disease therapy
Lou Gehrig's disease - also known as amyotrophic lateral sclerosis - is an incurable,
fatal disease that affects as many as 30,000 individuals in the US. But a new study
published in the Journal of Neuroscience suggests a copper compound could be used
in therapy for the condition.
Potential to treat ALS with heart failure drug
Research from the Washington University School of Medicine in St. Louis, MO,
suggests a medication used to treat heart failure could be adapted to treat amyotrophic
lateral sclerosis.

The ice bucket challenge

Recently, the ALS Association have been attempting to raise awareness of ALS through
the ice bucket challenge: a social media campaign that has spread across the world
using the hashtags #icebucketchallenge, #alsicebucketchallenge, and #strikeoutals.
For the fundraising scheme, people are challenged to drench themselves using a
bucket filled with ice and water or donate money to the charity. After an icy soaking, the
individual is then able to nominate further people to take the challenge.
The ice bucket challenge has proven to be extremely popular, with a whole host of highprofile personalities ranging from Bill Gates to Lady Gaga taking part.
By 25 August 2014, donations to the ALS Association from the ice bucket
challenge reached $79.7 million. In comparison, during the same timeframe in
2013 charity received $2.5 million in donations. This figure is good news for
researchers attempting to understand the causes of this disease and find
effective treatments for this currently fatal condition.
During a six-week period (August through mid-September 2014) The ALS Association
received $115 million in donations due to the ice bucket challenge. Forbes puts the total
donations at over $220 million, some $47.5 million of which has already been allocated
to fund research, according to the ALS Association website.
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Additionally, the ice bucket challenge brought in more than $17 million to ALS Canada,
compared to less than $7 million raised in 2013. This money has already been allocated
to support families already coping with ALS, as well as to fund a variety of research
projects that would otherwise be unlikely to receive funding.
In fact, $100,000 grants have been given to five different research teams across four
Canadian universities to help them investigate innovative hypotheses not currently
being investigated anywhere else.
Another $500,000 has been put towards a clinical trial of pimozide, an anti-psychotic
drug used to treat schizophrenia. This drug is being investigated for its potential to

strengthen the area where motor neurons connect the brain to muscles. If successful,
pimozide may be helpful in allowing muscles to function longer, delaying the
progression of ALS symptoms.